Trust Rewards Plan Document

Texas Medical Liability Trust (“TMLT”) has implemented the TMLT Trust Rewards Program (the “Program”) effective January 1, 2012. The details, terms, and conditions of the Program are contained in this Plan Document dated as of January 1, 2012.

1. Definitions

a. “Board” refers to the Board of Trustees of TMLT, including any committee thereof that is duly authorized and empowered to take actions regarding the Program.

b. “Disability” means that an individual insured physician of TMLT (1) is unable to practice medicine in his or her trained specialty due to a medically determinable physical or mental impairment, and (2) is under a physician’s care for such impairment and it is expected to be permanent or is expected to last for a continuous period of not less than twelve (12) months.

c. “Participant” refers to an individual insured physician of TMLT, who is otherwise qualified to participate in the TMLT Trust Rewards Program, and who is not subject to any surcharge assessed by TMLT.

d. “Retirement” means the complete and permanent withdrawal from the practice of medicine by a Participant if, at the time of such Retirement, the Participant (1) holds a medical license in good standing with the Texas Medical Board, (2) is 50 years of age or older, and (3) has been insured continuously with TMLT for at least three consecutive years immediately preceding Retirement.

e. “Suspension Period” means a period of time of sixty (60) months or less.

f. “Trust Rewards Account” and/or “Account” refers to the account established by TMLT on behalf of and for the benefit of a Participant pursuant to this Plan Document.

2. Eligibility for a Trust Rewards account

a. The Board, in its sole discretion, shall determine which Participant, Participants or class of Participants shall be eligible for a Trust Rewards Account.

b. The Board may alter, amend, suspend, terminate, or otherwise change its determination regarding eligibility in its sole discretion and without prior notice to the Participants or class of Participants.

c. Only Participants are eligible for a Trust Rewards Account. No other person, party or entity shall be eligible for a Trust Rewards Account.

d. All determinations regarding eligibility for a Trust Rewards Account shall be made by the Board and such determinations shall be final and non-appealable by any Participant.

3. Funding for a Trust Rewards account

a. The Board, in its sole discretion, shall determine if and when funds will be made available for the benefit of the Trust Rewards Accounts.

b. The Board, for each and any allocation of funds to be made available for the benefit of the Trust Rewards Accounts, shall determine the method and formula to be used to determine the allocation for each Participant.

c. The Board’s determination whether or not to make funds available for the benefit of the Trust Rewards Accounts may be made periodically, but the Board’s determinations are not intended to be made less frequently than annually.

d. Any funds made available for the benefit of the Trust Rewards Accounts shall be unrestricted surplus of TMLT until and unless distributed to the Participant and, as such, remain available to TMLT for the satisfaction of policyholder obligations and general creditors. No Participant shall have any individual claim to any funds made available for the benefit of the Trust Rewards Accounts until and unless such funds are distributed to the Participant.

e. All determinations regarding funding for the Trust Rewards Account shall be made by the Board and such determinations shall be final and non-appealable by any Participant.

4. Distribution of Trust Rewards account funds

a. Funds allocated to a Participant’s Account, if any, can only be distributed to the Participant upon his or her death, Disability, or Retirement. The Board shall determine whether any condition to the distribution has been satisfied in its sole, good faith discretion.

b. Except as otherwise set forth in this Section 4(b), any amounts allocated to or included in a Participant’s Account, if any, will be forfeited by the Participant if the Participant ceases to be insured by TMLT for any reason other than his or her death, Disability, or Retirement, or if the Participant otherwise fails to satisfy any other condition to a distribution that has been established by the Board. Notwithstanding the foregoing, if a Participant (1) temporarily ceases to be insured by TMLT for a period of time not exceeding a Suspension Period, (2) does not during such Suspension Period obtain medical liability insurance from a third party, and (3) after such Suspension Period, becomes a Participant prior to his or her death, Disability, or Retirement, then such Participant’s Account shall include any amounts allocated to or included in such Participant’s Account immediately prior to the beginning of such Suspension Period.

c. TMLT reserves the right to require the submission of reasonable evidence of the Participant’s death, Disability, or Retirement prior to the distribution of any funds, which evidence may include an affidavit and/or notarized statement of fact.

d. In the event of a distribution of Trust Rewards Account funds due to the death of the Participant, TMLT shall make the distribution to the Participant’s estate or designated practice group.

e. Any distribution of amounts allocated to or included in a Participant’s Account will be made within ninety (90) days of TMLT’s confirmation of the Participant’s death, Disability, or Retirement. The Board may establish additional policies regarding the timing of the distribution of amounts payable under individual Trust Rewards Accounts following the effective date of the Participant’s death, Disability, or Retirement.

f. The Board, in its sole discretion, shall determine if the conditions for distribution of a Participant’s Account have been satisfied.

g. The Board may alter, amend, suspend, terminate, or otherwise change the requirements for distribution of funds allocated to the Trust Rewards Account in their sole discretion and without prior notice to the Participants or class of Participants.

5. General

a. The Board may withdraw, cancel or modify this Plan Document without notice. Any withdrawal, cancellation or modification of this Plan Document will be evidenced by a resolution of the Board. This Plan Document shall be amended to evidence such action of the Board, and the amendment shall be mailed to the Participant’s address on record with TMLT.

b. A Participant’s Account, and any funds allocated thereto, cannot be transferred to any other person or entity, except the Participant may assign any final distribution of funds from the Account to the medical practice at which the Participant is employed and/or practicing at the time of the final distribution. The Participant may make the assignment at any time, and may amend or withdraw the assignment at any time as he or she deems necessary.

c. The Program shall be governed by the laws of Texas without regard to principles of conflict of laws. For any dispute arising under the Program, jurisdiction and venue shall be in Travis County, Texas. Participant hereby consents to the exclusive jurisdiction and venue of such courts with respect to such disputes.

d. The Program is intended to be in full conformity with the governing law. If any provision of the Program conflicts with such governing law, such provision shall be deemed to be modified to comply with such law.

e. Any provision of the Program that is prohibited or unenforceable in any jurisdiction, shall, as to such jurisdiction, be in effect to the extent of such prohibition or unenforceability without invalidating the remaining provisions of the Program or effecting the validity or enforceability of such provisions in any other jurisdiction.